Organization
LIFECARE MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON M COOPER (PRESIDENT)
(903) 792-0754
Entity
Organization
Contact information
Practice address
4506 TEXAS BLVD, TEXARKANA, TX 75503-3027
(903) 792-0754
(903) 792-0756
Mailing address
4506 TEXAS BLVD, TEXARKANA, TX 75503-3027
(903) 792-0754
(903) 792-0756
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
07/04/2006
Last updated
11/21/2007
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